[The effect of oxygen deficiency on the fine structure of the myocardium in the arrested and isolated, evacuated beating heart of rats].
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Biomedical subjects
Publications and source records attributed to H Nier.
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In 25 calves an atrio-ventriculo-aortic bypass was performed and the metabolism and the regulation of coronary blood flow during stepped assistance of the left ventricle was studied. With mean aortic blood pressure kept constant stepped decrease in left ventricular pressure from 120 to 0 mmHg diminished myocardial oxygen consumption from 7.7 to 1.9 ml O2/min X 100 g. Increasing right ventricular pressure by banding the pulmonary artery with left ventricular pressure and mean aortic pressure kept constant the oxygen uptake of the left ventricle increased about 20.7 +/- 32.% when measured by Fick's principle but remained unchanged when calculated from hemodynamic parameters of the left ventricle (-1.5 +/- 3.5%). At constant coronary perfusion pressure coronary blood flow decreased when left ventricular pressure was reduced from 120 to 100 mmHg. Further decrease in left ventricular pressure to 0 mmHg showed no effect on coronary blood flow. Increasing heart rate from 152 +/- 9 to 208 +/- 8 b.p.m. enhanced myocardial oxygen uptake of the assisted heart about 59.0 +/- 11.4% while resistance to flow decreased about 40.4 +/- 2.8%. These results show that the metabolic regulation of coronary blood flow is still acting even in the assisted left heart.
BACKGROUND/AIMS: This retrospective study analyzes the influence of different factors on morbidity and mortality after surgical treatment of peptic ulcer. METHODOLOGY: At the Municipal Hospital of Offenbach, Germany, from 1985-1996, 485 patients underwent surgery. RESULTS: Of the 485 patients, 70.7% (343) were diagnosed to have duodenal ulcer and 29.2% (142) had suffered from gastric ulcer. During this period, 79.2% (384) of the operations were performed under emergency conditions because of acute complications (56% of these with perforation, 20% with penetration, 24% with ulcer bleeding), whereas the rest was done electively. Two hundred and ninety-one (60%) patients were male, the average age was 59 years and 71.7% (348) of the patients had certain concomitant diseases. We observed complications in 48% of the cases with a total postoperative mortality of 21%. CONCLUSIONS: Between 1985 and 1996 the total number of ulcer surgeries performed at the Municipal Hospital Offenbach per year has stayed almost constant. However, a definite increase of acute operations in addition to a decrease of elective interventions was noticed. The dissatisfying results of surgical treatment of peptic ulcer after the introduction of proton pump inhibitors seems to be the consequence of the negative selection of patients mentioned above. A connection could be proved between the age and condition of the patient, the type of the surgical intervention (acute or elective) and the morbidity and mortality after the surgery.
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